中文摘要：

目的探讨引起巨细胞病毒（CMV）感染患儿听力损害的相关因素分析。方法依据脑干听觉诱发电位（BAEP）检测结果将158例CMV感染患儿分为听力正常组（n=117,BAEP≤35）和听力异常组（n=41,BAEP〉35）。收集两组患儿一般资料、血常规、肝功能、尿液及乳汁病毒拷贝数等进行回顾性分析;绘制受试者工作特征曲线（ROC）预测导致BAEP异常的CMV-DNA病毒载量;采用Spearman秩相关分析对尿CMV-DNA拷贝数与听力损害程度、血小板计数间进行相关性分析。结果听力异常组血小板异常率、肝功能异常率和尿CMV-DNA拷贝数均高于听力正常组（P〈0.01）。ROC分析结果显示,当尿CMV-DNA拷贝数为1.415×10^6/m L时,预测病毒载量导致听力损伤的敏感性为46.3%,特异性为93.2%。相关性分析结果显示,听力损害的程度随着CMV-DNA拷贝数的增加而增高（r=0.382,P〈0.01）;血小板计数和尿CMV-DNA拷贝数之间存在负相关（r=-0.233,P=0.003）。结论尿CMV-DNA病毒载量可能与CMV感染导致神经性听力障碍相关;当CMVDNA载量达到1.415×10^6/m L时,更易出现听力损害。存在血小板减少的CMV感染患儿,应加强听力监测。

英文摘要：

Objective To investigate the risk factors for hearing impairment induced by cytomegalovirus（CMV） infection in children. Methods One hundred and fifty-eight children diagnosed with CMV infection were enrolled as subjects. Based on the results of the brainstem auditory evoked potential（BAEP） test, patients were classified into normal hearing group（n=117; BAEP ≤35） and abnormal hearing group（n=41; BAEP〉 35）. A retrospective analysis was performed on the general information, routine blood indices, liver function, copy number of CMV-DNA in urine and breast milk. The receiver operating characteristic（ROC） curve was used to predict the copy number of CMV-DNA resulting in abnormal BAEP. The Spearman rank correlation analysis was used to test the correlations of the copy number of CMV-DNA in urine with the degree of hearing impairment and platelet count. Results The incidence rates of platelet abnormality and abnormal liver function and the copy number of CMV-DNA in urine were significantly higher in the abnormal hearing group than in the normal hearing group（P〈0.01）. According to the ROC curve, the copy number of CMV-DNA in urine had a sensitivity of 46.3% and a specificity of 93.2% in predicting hearing impairment when it reached 1.415×10^6 per m L. The results of correlation analysis showed that the degree of hearing impairment was positively correlated with the copy number of CMV-DNA（r=0.382, P〈0.01）; the platelet count was negatively correlated with the copy number of CMV-DNA in urine（r=-0.233, P=0.003）. Conclusions An increased copy number of CMV-DNA in urine might be a risk factor for hearing impairment induced by CMV infection. Children are likely to have hearing impairment when the copy number of CMV-DNA reaches 1.415×10^6 per m L. The monitoring of hearing should be strengthened in CMV-infected children with a decreased platelet count.